NPI | 1194143537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: HI APRN-1711) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI APRN-1711) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2023-02-13 |